• MeSH
• lidé MeSH
• nemoci autonomního nervového systému * diagnóza   klasifikace   terapie   MeSH
• nemoci míchy komplikace   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Sbírka básní s přírodní tématikou, které doplňují i barevné ilustrace. Autorkou je česká lékařka.

• MeSH
• duševní procesy MeSH
• příroda MeSH
• umění MeSH
• Publikační typ
• poezie MeSH
• sbírky MeSH
• Geografické názvy
• Česká republika MeSH

• Konspekt
• Česká poezie
• NLK Obory
• humanitní vědy a umění
• NLK Publikační typ
• obrazy

Worldwide stroke is the second leading cause of death and the third leading cause of death and disability combined. The estimated global economic burden by stroke is over US$891 billion per year. Within three decades (1990-2019), the incidence increased by 70%, deaths by 43%, prevalence by 102%, and DALYs by 143%. Of over 100 million people affected by stroke, about 76% are ischemic stroke (IS) patients recorded worldwide. Contextually, ischemic stroke moves into particular focus of multi-professional groups including researchers, healthcare industry, economists, and policy-makers. Risk factors of ischemic stroke demonstrate sufficient space for cost-effective prevention interventions in primary (suboptimal health) and secondary (clinically manifested collateral disorders contributing to stroke risks) care. These risks are interrelated. For example, sedentary lifestyle and toxic environment both cause mitochondrial stress, systemic low-grade inflammation and accelerated ageing; inflammageing is a low-grade inflammation associated with accelerated ageing and poor stroke outcomes. Stress overload, decreased mitochondrial bioenergetics and hypomagnesaemia are associated with systemic vasospasm and ischemic lesions in heart and brain of all age groups including teenagers. Imbalanced dietary patterns poor in folate but rich in red and processed meat, refined grains, and sugary beverages are associated with hyperhomocysteinaemia, systemic inflammation, small vessel disease, and increased IS risks. Ongoing 3PM research towards vulnerable groups in the population promoted by the European Association for Predictive, Preventive and Personalised Medicine (EPMA) demonstrates promising results for the holistic patient-friendly non-invasive approach utilising tear fluid-based health risk assessment, mitochondria as a vital biosensor and AI-based multi-professional data interpretation as reported here by the EPMA expert group. Collected data demonstrate that IS-relevant risks and corresponding molecular pathways are interrelated. For examples, there is an evident overlap between molecular patterns involved in IS and diabetic retinopathy as an early indicator of IS risk in diabetic patients. Just to exemplify some of them such as the 5-aminolevulinic acid/pathway, which are also characteristic for an altered mitophagy patterns, insomnia, stress regulation and modulation of microbiota-gut-brain crosstalk. Further, ceramides are considered mediators of oxidative stress and inflammation in cardiometabolic disease, negatively affecting mitochondrial respiratory chain function and fission/fusion activity, altered sleep-wake behaviour, vascular stiffness and remodelling. Xanthine/pathway regulation is involved in mitochondrial homeostasis and stress-driven anxiety-like behaviour as well as molecular mechanisms of arterial stiffness. In order to assess individual health risks, an application of machine learning (AI tool) is essential for an accurate data interpretation performed by the multiparametric analysis. Aspects presented in the paper include the needs of young populations and elderly, personalised risk assessment in primary and secondary care, cost-efficacy, application of innovative technologies and screening programmes, advanced education measures for professionals and general population-all are essential pillars for the paradigm change from reactive medical services to 3PM in the overall IS management promoted by the EPMA.

• Publikační typ
• časopisecké články MeSH

Publikace se zaměřuje na nemoci páteřní míchy a páteře. Určeno odborné veřejnosti.

• MeSH
• mícha MeSH
• nemoci míchy MeSH
• nemoci páteře MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• neurologie
• NLK Publikační typ
• kolektivní monografie

Multiple sclerosis (MS) is a demyelinating and neurodegenerative autoimmune disease of the central nervous system (CNS) damaging myelin and axons. Diagnosis is based on the combination of clinical findings, magnetic resonance imaging (MRI) and analysis of cerebrospinal fluid (CSF). Metabolomics is a systematic study that allows us to track amounts of different metabolites in a chosen medium. The aim of this study was to establish metabolomic differences between the cerebrospinal fluid of patients in the early stages of multiple sclerosis and healthy controls, which could potentially serve as markers for predicting disease activity. We collected CSF from 40 patients after the first attack of clinical symptoms who fulfilled revised McDonald criteria of MS, and the CSF of 33 controls. Analyses of CSF samples were performed by using the high-performance liquid chromatography system coupled with a mass spectrometer with a high-resolution detector. Significant changes in concentrations of arginine, histidine, spermidine, glutamate, choline, tyrosine, serine, oleic acid, stearic acid and linoleic acid were observed. More prominently, Expanded Disability Status Scale values significantly correlated with lower concentrations of histidine. We conclude that these metabolites could potentially play a role as a biomarker of disease activity and predict presumable inflammatory changes.

• MeSH
• biologické markery mozkomíšní mok   MeSH
• centrální nervový systém MeSH
• histidin MeSH
• lidé MeSH
• mastné kyseliny MeSH
• metabolomika MeSH
• roztroušená skleróza * diagnostické zobrazování   mozkomíšní mok   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

V léčbě nádorových onemocnění se objevují stále účinnější léčebné strategie, které však s sebou přinášejí i nové nežádoucí účinky. Průlomem je použití imuno­‐onkologické léčby, kam patří léčba inhibitory kontrolních bodů. Bohužel s touto léčbou se pojí řada imunitně zprostředkovaných nežádoucích účinků, které také mohou postihnout nervový systém. Nejčastěji se objevuje myastenie, Guillainův­‐Barrého syndrom, neuropatie, aseptická meningitida, mononeuritis multiplex, encefalitida a transverzální myelitida. Dalšími léčivy, která potenciálně mohou vést k postižení nervového systému, jsou inhibitory BRAF a MEK, jež se například používají v léčbě metastazujícího melanomu.

More effective treatment strategies have been appearing in the treatment of cancer, but they also bring new unpleasant side effects with them. A breakthrough is the use of immuno-oncology therapy, which includes checkpoint inhibitors. Unfortunately, this treatment relates to number of immune-mediated adverse effects, which may affect also the nervous system. Myasthenia gravis, Guillain-Barré syndrome, neuropathy, aseptic meningitis, mononeuritis multiplex, encephalitis and transverse myelitis are the most common neurotoxic side effects. Other drugs that can lead to damage to the nervous system are BRAF and MEK inhibitors, for example used in the treatment of metastatic melanoma. Knowledge of these immune-related side effects is necessary for prompt diagnosis and treatment. Immediate discontinuation of oncology therapy, administration of high doses of corticosteroids, intravenous immunoglobulins or exchange plasmapheresis is recommended.

• MeSH
• dospělí MeSH
• ganciklovir aplikace a dávkování   terapeutické užití   MeSH
• Guillainův-Barrého syndrom diagnóza   etiologie   terapie   MeSH
• hormony kůry nadledvin aplikace a dávkování   terapeutické užití   MeSH
• imunoterapie metody   MeSH
• inhibitory kontrolních bodů aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• lidé MeSH
• MAP kinasy kinas (kinas) antagonisté a inhibitory   škodlivé účinky   MeSH
• melanom farmakoterapie   MeSH
• meningitida aseptická diagnóza   etiologie   terapie   MeSH
• meningoencefalitida diagnóza   etiologie   terapie   MeSH
• neurotoxické syndromy diagnóza   etiologie   farmakoterapie   MeSH
• protinádorové látky imunologicky aktivní * aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• protoonkogenní proteiny B-raf antagonisté a inhibitory   škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Při zásahu elektrickým proudem záleží na napětí, délce průchodu proudu, typu proudu a na tělesné lokalizaci. Zásah bleskem je vždy nebezpečný a je spojen s vysokou mortalitou. Může se jednat o přímý zásah, nepřímý zásah svedený z okolních struktur, či zásah zemními proudy. Ze struktur nervového systému bývají často poškozeny periferní nervy, ale také mozek, mícha, svaly. Poškození elektrickým výbojem jsou často těžšího stupně, jejich léčba je zdlouhavá, výsledná úprava poškozeného nervového systému nebývá dokonalá. Důležitá je proto prevence, a to u úrazů elektrickým proudem i úrazů způsobených bleskem.

When an electric shock occurs, it depends on the voltage, the length of the current, the type of current and where is the localization on the human body. A lightning strike is always very dangerous and connecting with a high mortality. A person can be affected by a direct hit, an indirect hit from surrounding structures, or a hit by ground currents. Nervous system can be damaged at the periphery (peripheral nerves), but also the brain, spinal cord, and muscles. Electric shock injuries are often of a more severe degree. The treatment is usually long-lasting. The final clinical outcome of the damaged nervous system is usually not perfect and may be incomplete. Prevention is therefore important, both for electric shocks and lightning injuries.

• MeSH
• kognitivní poruchy etiologie   MeSH
• lidé MeSH
• nervová tkáň zranění   MeSH
• paralýza etiologie   MeSH
• poranění bleskem MeSH
• poranění elektrickým proudem * MeSH
• poranění nervového systému terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

During the last 5-7 years, tremendous progress was achieved in the reperfusion treatment of acute ischaemic stroke during its first few hours from symptom onset. This review summarizes the latest evidence from randomized clinical trials and prospective registries with a focus on endovascular treatment using stent retrievers, aspiration catheters, thrombolytics, and (in selected patients) carotid stenting. Novel approaches in prehospital (mobile interventional stroke teams) and early hospital (direct transfer to angiography) management are described, and future perspectives ('all-in-one' laboratories with angiography and computed tomography integrated) are discussed. There is reasonable chance for patients with moderate-to-severe acute ischaemic stroke to survive without permanent sequelae when the large-vessel occlusion is removed by means of modern pharmaco-mechanic approach. Catheter thrombectomy is now the golden standard of acute stroke treatment. The role of cardiologists in stroke is expanding from diagnostic help (to reveal the cause of stroke) to acute therapy in those regions where such up-to-date Class I. A treatment is not yet available.

• MeSH
• cévní mozková příhoda * terapie   komplikace   MeSH
• endovaskulární výkony * metody   MeSH
• ischemická cévní mozková příhoda * komplikace   MeSH
• ischemie mozku * terapie   komplikace   MeSH
• lidé MeSH
• prospektivní studie MeSH
• reperfuze škodlivé účinky   MeSH
• stenty škodlivé účinky   MeSH
• trombektomie metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Ischemická cévní mozková příhoda je závažný stav zatížený vysokou mortalitou a značně vysokým rizikem trvalých funkčních následků. Léčba akutní ischemické cévní mozkové příhody prodělala trombektomiepři využití mechanické k okluze velkých cév mozku v porovnání s nejlepší medikamentózní terapií zahrnující systémovou trombolýzu, a zásadně tak změnily dosud zavedené paradigma léčby. V současné době je k dispozici široký výběr nástrojů pro mechanickou a nové jsou ve vývoji. Tato práce si klade za cíl shrnout současné možnosti léčby akutní ischemické cévní mozkové příhody metodami mechanické trombektomie a nastínit i další aspekty terapie tohoto onemocnění.

Ischemic stroke is a severe condition with a high mortality and a serious risk of permanent functional dis- ability. The treatment of acute ischemic stroke has undergone a number of major changes in recent years - from systemic thrombolysis to the wide range of current mechanical thrombectomy modalities. Studies such as MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME and others have demonstrated improved outcomes in patients with large vessel occlusion when mechanical thrombectomy was used compared with best medical treatment including systemic thrombolysis. These results have completely changed the treatment paradigm. Currently, a wide variety of endovascular tools are available for mechanical thrombectomy and new ones are still under development. This paper aims to summarize the current options for the treatment of ischemic stroke by mechanical thrombectomy and to outline other therapy aspects of this disease.

• MeSH
• ischemická cévní mozková příhoda * dějiny   terapie   MeSH
• klinická studie jako téma MeSH
• lidé MeSH
• mechanická trombolýza * metody   ošetřování   přístrojové vybavení   škodlivé účinky   MeSH
• trombektomie metody   ošetřování   přístrojové vybavení   škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

INTRODUCTION: The influence of breastfeeding and it ́s duration on the course of multiple sclerosis (MS) is unclear. Here we analyzed a real-world data for breastfeeding women with MS and their disease course collected from a Czech national registry ReMuS. OBJECTIVES: To identify risk factors associated with not initiating breastfeeding after delivery, to analyze the impact of breastfeeding on the MS disease course, evaluate the assumption, that breastfeeding is not harmful in MS patients, and compare the disease course by breastfeeding status. MATERIALS AND METHODS: Using propensity score matching we compared Expanded Disability Status Scale (EDSS), confirmed disease worsening (CDW) and annual relapse rate (ARR) in breastfeeding and non-breastfeeding MS patients according to disease duration, disease modifying treatment (DMT) before pregnancy, last EDSS score before conception, age, and ARR during pregnancy. We also compared these parameters between breastfeeding patients not using a DMT and non-breastfeeding patients who resumed DMT within 3 months after delivery. EDSS, ARR, and CDW were collected at 12, 24, and 36 months after delivery. RESULTS: A total of 1681 pregnancies that ended in delivery were analyzed from 2013 through 2020. Change in ARR and EDSS values and 6-months CDW did not significantly differ between the analyzed groups. Compared with non-breastfeeding women who resumed DMT early after delivery, breastfeeding women with MS did not experience worse clinical outcomes even without initiating a DMT. DISCUSSION: Breastfeeding in Czech women with MS did not negatively affect the disease course and can be supported. Patients with MS can be treated with certain DMTs alongside breastfeeding and there is no need to stop breastfeeding, if the patient is clinically stable.

• MeSH
• kojení MeSH
• lidé MeSH
• progrese nemoci MeSH
• recidiva MeSH
• relabující-remitující roztroušená skleróza * farmakoterapie   MeSH
• roztroušená skleróza * farmakoterapie   epidemiologie   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH